When I started my practice, I wanted to accept insurance so I could serve and help as many people as possible. I had also heard that accepting insurance would make my practice less volatile during economic downturns and make me more money. All of this sounded fantastic! So I set out to learn as much as I could about what I needed to do.
I didn’t find a comprehensive resource to guide massage therapists through the quagmire of insurance, due in part because insurance laws vary from state to state. I also learned that there are different types of insurance that may or may not cover massage, and that getting credentialed for all of them is time consuming and not at all streamlined. Surprised?
I started with applying for an NPI (National Provider Identifier) number. It’s been a while but I recall it being relatively painless and free. Once you submit your application, your number is assigned immediately. This number is required to file any insurance claims and apply for health insurance credentialing. I would recommend that all massage therapists do this just in case you have an existing client who has an auto insurance or Workers’ Compensation claim and wants you to provide care.
To file an insurance claim, you’ll need a prescription from a referring physician. In my experience, most health care professionals really don’t know much about massage therapy or what recommendations to make to achieve the best outcome. I created my own prescription form that is fast and easy to complete that I can email to their office or provide hard copies of for their staff to keep on file. This keeps my records consistent, makes me look professional and helps clients get the best treatment. I also made a video to walk them through completing the form (be warned that my massage skills vastly exceed my video production abilities).
I wanted to get on the provider lists of as many major health insurance companies as possible. I had received a letter from American Specialty Health (ASH) inviting me to join their network (they must monitor new massage business trade name filings or something). Basically, ASH is a third party that offers wellness plans to health insurance companies. I also discovered another similar company named CorVel. Both of these companies contract with you to discount your services to their members whether you are paid directly from clients or filing a claim. And then there’s CAQH, which is a health insurance credentialing company. All three have a lengthy application and approval process.
So let’s get down to the real question: Did belonging to these networks help me grow my practice? Only ASH did and I still have regular clients who I got as referrals from an ASH member. Having the NPI came in handy when the receptionist at a doctor’s office I solicited was in a car accident and came to me for massage (she’s still a regular client). I’m sure every auto insurance carrier is different but I found the process to be fairly simple and got paid my full fee within a month of submission. Neither CorVel nor CAQH have proven worth the time to complete the application for me, but if you get a lot of physician referrals that may not be the case.
I also provided massage on a lien for a personal injury victim (meaning I would be paid once the case was settled). After doing eight sessions with him, I decided I needed him to pay me instead of waiting for his settlement. He continued to come in weekly for a couple of months but then opted for physical therapy that was provided on a lien. I understood completely since he wasn’t working due to his injuries and am glad I chose to discontinue working that way. I submitted the bill for his services over two years ago and am hoping to receive payment soon (his case has finally settled).
At this point in time, I don’t accept any health insurance but I do accept payment with FSA (Flexible Spending Account) debit cards. Since I stopped offering traditional injury work and only do Ashiatsu now, not many people who contacted me through ASH were booking so I resigned my affiliation with them. I’ll never work on a lien again but will gladly give personal injury clients receipts that they can submit and be reimbursed for upon settlement. I would readily take on auto insurance and Workers’ Comp claims for existing or referred clients because billing the full amount would bring in more income than my typical frequency or package discounts. Overall, trying different ways to bring in clients has paid off for me and helped me build a practice that I love!
Do you or have you worked with insurance clients? What tips or cautions do you have? If you don’t see a comment box, please click the Leave a comment link below to share. Thank you!